OF mental health care and mentally ill

Young Schema Questionnaire

Unlike the PBQ, which is designed to correlate with Axis II disorders, the Young Schema Questionnaire YSQ (Young & Brown, 1990) assessesEMS, which cross-cut DSM-IV categories and appear in normal personalities as well.EMSare trait-like constructs that are theorized to underlie personality disorders and chronic depressions and anxiety. They are present in normal personalities and contribute to psychopathology depending on their pervasiveness, persistence, and degree of impairment caused by their activity.

The YSQ is a 205-item, self-report questionnaire that asks respondents to rate, on a 6-point Likert scale, the degree to which each item describes them (from 1 “Completely untrue of me” to 6 “Describes me perfectly”). YSQ items are grouped by each of the 16 original schemas identifi ed by Young (1990), and it is not necessary for respondents to be “blind” to theEMSthey are endorsing. The YSQ is used primarily for clinical purposes. Total scores are not calculated; rather, clinicians look for high-scoring items and patterns. Scores of5’s and6’s alert the clinician to the likelihood of andEMS.

If a patient has three or more high scores for a particular schema, the schema is usually relevant and worthy of exploration (Young et al., 2003). The clinician then uses the highscoring items to direct a clinical interview for relevant history in order to build a case conceptualization. A short form of the YSQ (YSQ–S1; Young, 1998) contains 75 items, the fi ve highest loading items found in factor analysis for each schema on the original form (Schmidt, Joiner, Young, & Telch, 1995). The short form has levels similar to those of the long form of internal consistency, parallel forms reliability, and concurrent validity (Stopa, Thorne, Waters, &Preston, 2001), and is used in research studies. The psychometric properties of the YSQ have been investigated by Schmidt et al. (1995) who found support, in factor analysis, for 12 of Young’s 16 original schemas. Another factor, Fear of Losing Control, not hypothesized by Young, was found in a student sample, but not in a patient sample. Social Undesirability did not emerge as a factor in either sample.

In the student sample, three higher order factors were identifi ed: Disconnection, Overconnection, and Exaggerated Standards. A large-scale Australian study of a clinical sample found Social Undesirability to be the only factor hypothesized by Young that failed to emerge (Lee, Taylor, & Dunn, 1999). An additional factor, containing items from Emotional Inhibition, refl ected inhibition of emotional expression and thus related to Fear of Loss of Control rather than Emotional Inhibition. In this sample, a higher order factor analysis yielded factors labeled Impaired Autonomy, Disconnection, Impaired Limits, and Overcontrol.

Comparisons were made between patients with Axis I and Axis II disorders. Those with Axis II diagnoses had signifi cantly higher scores on all of the derived scales except Subjugation and Vulnerability. The scales with the largest mean differences loaded on two of the higher order factors, Disconnection and Impaired Limits. “This is consistent with the view that people with a personality disorder are much more likely to have a disturbance in their primary attachment and problems in limit setting than people with only an Axis I diagnosis “(Lee et al., 1999, p. 450).

In addition, the higher order factors of Disconnection and Impaired Autonomy are very similar to sociotropy and autonomy, respectively. Thus, the study by Lee et al. (1999) demonstrates that the YSQ has good internal consistency and that its primary factor structure is stable across clinical samples from different countries and for varying degrees of psychopathology (Axis I and Axis II). The higher order factor structure is consistent with the theoretical distinction between interpersonal relatedness and autonomous achievement, as is Beck’s sociotropy and autonomy.